Councillors have voiced strong concerns about “inequalities” in dental care after it was revealed more dental practices are charging fees.

More practices in Irvine, Saltcoats and Largs are opting to introduce charges but people who can’t afford them are being left behind.

The reduction in NHS work is particularly affecting adult patients, who are being encouraged by their practice to transfer to private plans. Most practices will continue to treat children.

The public dental service has experienced an increase in emergency appointments, with additional sessions being implemented in addition to the level of routine care being reduced in order to support emergency appointments. Waiting lists have increased.

From the 26 general dental practitioners listed with the health board who are committed to providing NHS care, four of these practices are accepting new NHS registrations, both adults and children, but have large waiting lists.

Largs, Irvine and Saltcoats are areas of particular concern where there is little or no access to NHS-committed practices due to a high level of recruitment issues, large waiting lists and practices choosing to become private.

Maintaining core provision for vunerable population is the main aim of the public dental service.

The Scottish Government has committed to reforming the current payment structure from November 1.

General dental practitioner (GDP) businesses can decide at any time to reduce or withdraw their NHS commitment and become either a wholly private business or provide limited NHS commitment.

Provost Anthea Dickson told the Integrated Joint Board:  “I found the report hugely depressing. All other services involve the public in trying to improve them. What we are seeing here is the exact opposite direction, I feel we have grossly underestimated the waiting lists.

“I know many people don’t try to go to the dentist, let alone be put on a waiting list. The waiting list would be a lot longer if people had more confidence.

“I hope with a new fee structure that might be able to help with the service, the inequalities are so huge and I would like something being done about that in the next six months.”

Board member Louise McDaid added: “I found it really depressing and if ever a paper demonstrated inequalities it was this, thank goodness for the NHS.

“I live in the North coast and someone told me Largs is refusing NHS unless you pay £18 a month for two scales and a couple of polishes and it’s a standing order.

“It is  really upsetting to read something like this given our priorities in the  IJB. I think there will be a public backlash on this, especially in these private dental practices where you set up a standing order and  if you don’t pay £18, you don’t have a service.

“They also say if you pay £18 you will get your children treated. We are coming into generations of those inequalities. I’m glad we are on top of this and I think it is going to become quite a big issue.”

Caroline Cameron, of the IJB chief office, said: “This isn’t just a local problem, it’s a national problem around access to dentistry across Scotland. Discussions are ongoing between NHS chief officers and the partnerships. It is about the way the service is configured.

“Hopefully as work progresses nationally, more levers can come out of it which can help these challenges locally.

“We are acutely aware in North Ayrshire we have people living in some of the most deprived areas of Scotland and that lack of access is exacerbated and to compound the problem private or independent options are not nearly affordable to people in every community.”